Abstract
We report the case of a 50-year-old Japanese woman with SAPHO (synovitis-acne-pustulosis-hyperostosis-osteomyelitis) syndrome. Radiographs showed osteosclerosis of the cervical and lumbar vertebrae, as well as osteosclerosis and osteolysis of the right femoral neck, resembling multiple metastatic bony lesions. Arriving at a diagnosis required hematological and imaging tests. Whole-body bone scintigraphy identified diffuse uptake from the lower cervical vertebrae to the lumbar vertebrae and marked uptake in the right femoral neck. However, with [18F]fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) scanning, abnormal [18F]FDG uptake was not detected in cervical and lumbar spine, or in the femoral neck. Bone biopsy showed signs of chronic nonspecific inflammation, rather than tumor or infection. Based on these findings, the patient was diagnosed with SAPHO syndrome unaccompanied by skin lesions, and administration of non-steroidal anti-inflammatory drugs provided pain relief.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
AM Chamot CL Benhamou MF Kahn (1987) ArticleTitleLe syndrome acne pustulose hyperostose ostite (SAPHO): resultants d'une enquate nationale Rev Rheum Mal Osteoartic 54 187–96 Occurrence Handle1:STN:280:BiiB3szosF0%3D
CL Benhamou AM Chamot MF Kahn (1988) ArticleTitleSynovitis-acne-pustulosis-hyperostosis-osteomyelitis (SAPHO); a new syndrome among the spondyloarthropathies? Clin Exp Rheumatol 6 109–12 Occurrence Handle2972430 Occurrence Handle1:STN:280:BiaD38bjtV0%3D
G Hayem CA Bouchaud K Benali S Roux E Palazzo OS Hoffman et al. (1999) ArticleTitleSAPHO Syndrome; a long-term follow-up study of 120 cases Semin Arthritis Rheum 29 159–71 Occurrence Handle10622680 Occurrence Handle10.1016/S0049-0172(99)80027-4 Occurrence Handle1:STN:280:DC%2BD3c%2Fos1eqsA%3D%3D
A Giedon W Holthusen LF Masel (1972) ArticleTitleSubacute and chronic symmetrical osteomyelitis Ann Radiol 15 329–42
B Björkten L Boquist (1980) ArticleTitleHistopathological aspects of chronic recurrent multifocal osteomyelitis J Bone J Surg 62-B 376–80
C Job-Deslandre S Krebs A Kahan (2001) ArticleTitleChronic recurrent multifocal osteomyelitis: five-year outcomes in 14 pediatric cases Joint Bone Spine 68 245–51 Occurrence Handle11394625 Occurrence Handle10.1016/S1297-319X(01)00276-7 Occurrence Handle1:STN:280:DC%2BD3Mzis12guw%3D%3D
GA Mandell SJ Contreras K Conard (1998) ArticleTitleBone scintigraphy in the detection of chronic recurrent multifocal osteomyelitis J Nucl Med 39 1778–83 Occurrence Handle9776287 Occurrence Handle1:STN:280:DyaK1cvkslWrsA%3D%3D
AG Jurik N Egung (1997) ArticleTitleMRI in chronic recurrent multifocal osteomyelitis Skelet Radiol 26 230–8 Occurrence Handle10.1007/s002560050227 Occurrence Handle1:STN:280:ByiB1MrnvFE%3D
H Orui M Takahara A Ishikawa M Takagi T Tsuchiya T Ogina (2002) ArticleTitleRadiological features of long bones in synovitis, acne, pustulosis, hyperostosis, osteitis syndrome and their correlation with pathological findings Mod Rheumatol 12 56–63
O Vittecoq LA Said C Michot O Mejjad JM Thomine P Mitrofanoff et al. (2000) ArticleTitleEvolution of chronic recurrent multifocal osteitis toward spondylarthropathy over the long term Arthritis Rheum 43 109–19 Occurrence Handle10643706 Occurrence Handle10.1002/1529-0131(200001)43:1<109::AID-ANR14>3.0.CO;2-3 Occurrence Handle1:STN:280:DC%2BD3c7gs1Gjsg%3D%3D
H Amital H Applbaum S Aamar (2004) ArticleTitleSAPHO syndrome treated with pamidronate: an open-label study of 10 patients Rheumatology 43 658–61 Occurrence Handle14983108 Occurrence Handle10.1093/rheumatology/keh149 Occurrence Handle1:CAS:528:DC%2BD2cXjsVektbk%3D
H Natsume S Tsubouchi M Inada S Ootsuka S Suzuki (2004) ArticleTitleSimultaneous spondylitis in the cervical and lumbar spine in SAPHO syndrome Rinsho Seikei Geka 39 737–41
H Kato Y Gonoji Y Aotake J Nakase S Miwa S Amaya (2005) ArticleTitleSAPHO syndrome with the severely destructive lesion of the cervical spine Rinsho Seikei Geka 40 949–53
H Watanabe T Shinozaki T Yanagawa (2000) ArticleTitleGlucose metabolic analysis of musculoskeletal tumors using 18 fluorine-FDG PET as an aid to preoperative planning J Bone Joint Surg 82-B 760–7 Occurrence Handle10.1302/0301-620X.82B5.9824
K Takeuchi (2003) ArticleTitleApplication of PET scanning in rheumatology Rheum Dis Semin 13 126–30
C Beckers X Jeukens C Ribbens B Andre S Marcelis P Leclercq et al. (2006) ArticleTitle(18)F-FDG PET imaging of rheumatoid knee synovitis correlates with dynamic magnetic resonance and sonographic assessments as well as with the serum level of metalloproteinase-3 Eur J Nucl Med Mol Imaging 33 275–80 Occurrence Handle16247604 Occurrence Handle10.1007/s00259-005-1952-3
K Umekita I Takajo S Miyauchi K Tsurumura S Ueno N Kusumoto et al. (2006) ArticleTitle[18F]fluorodeoxyglucose positron emission tomography is a useful tool to diagnose the early stage of Takayasu's arteritis and to evaluate the activity of the disease Mod Rheumatol 16 243–7 Occurrence Handle16906376 Occurrence Handle10.1007/s10165-006-0485-3
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Takeuchi, K., Matsusita, M. & Takagishi, K. A case of SAPHO (synovitis-acne-pustulosis-hyperostosis-osteomyelitis) syndrome in which [18F]fluorodeoxyglucose positron emission tomography was useful for differentiating from multiple metastatic bone tumors. Mod Rheumatol 17, 67–71 (2007). https://doi.org/10.1007/s10165-006-0536-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10165-006-0536-9